GHP January 2016

ghp January 2016 | 23 health & social care Professional Lead for Public Health Nursing Perceptions of public health have radically changed over the 19th and 20th century. Communicable infec- tious diseases are no longer the issue they once were. This is by and large because people can now expect to live in a decent home, breathe clean air and drink water free from disease. This has all been alongside investment in vaccination programmes. But we are not entirely without threat. Lifestyle related illnesses are on the rise needing smoking cessation and obesity services and there remain inequalities in society which lead to health inequalities. The current government talks about working to tackle disease prevention, lifestyle changes and public health services but the finances are doing the exact opposite. By placing public health “outside the NHS”, it is possible to flatline or even increase the NHS budget while simultaneously removing those funds that make it sustainable. Nurses working in some of our most deprived and vulnerable areas will be horrified to hear that this is happening. Let us be clear. Cutting public health budgets – intended to prevent health problems before they start – is incredibly short-sighted, and risky. There is barely a person in the UK who will not be needing public health services at some time in their life, covering everything from obesity to tobacco and sexual health to alcohol. Applying these cuts indiscriminately leaves deprived areas facing an increased burden and is undoubtedly going to add to inequality and the score of human misery. People living in deprived communities are more likely to suffer poor health, much of it caused by poor diets, smoking and alcohol. Ultimately, choosing not to invest in prevention will affect the whole NHS, the economy and the nation as a whole. Rather than being about figures on a balance sheet, many people will face preventable poor health because help and advice is not available, while families and communities are plunged into a spiral of health depri- vation which becomes almost impossible to break. Britain has the fourth highest child mortality rate in Europe, something which would horrify the public health leaders of a hundred years ago. With 1630 deaths per one million children, compared with only 911 in Finland, we are from delivering the best possi- ble care to children. Inequality and poverty are at the heart of this problem: the UK’s child poverty rates and differences in income are linked with its heightened rate of child death. The Government has a duty to every child but cuts to services, from public health to social care, are exacerbating child health inequalities amongst the poorest in society. Efforts must be made to eradicate this inequality. The UK spends the lowest percentage of any Western country on health – just 6.9 per cent of national income. Tragically, a lack of funding is translating into tragic outcomes for vulnerable children. This year has been a time when radical action could and should have been taken. Time will tell how serious the consequences of not doing so may turn out to be. By Helen Donovan, Royal College of Nursing